156957800 Atlas Sectiuni Anatomie

5/23/2018 156957800 Atlas Sectiuni Anatomie

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1. Frontal sinus2. Falx cerebri3. Cerebral cortex4. Temporalis muscle5. Corpus callosum6. Septum pellucidum7. Internal capsule8. Lateral ventricle9. Parietal bone

10. Hypodermis11. Skin12. Superior sagittal sinus

13. Thalamus14. Lentiform nucleus15. Caudate nucleus16. Yellow bone marrow (MRI only)

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Systemic Descriptions

Cardiovascular SystemThe superior sagittal sinus (12) drains blood from the brain

(SST Figure 21-13).

Integumentary SystemThe skin (11) of the scalp covers the loose connective tissue

of the hypodermis (10), which contains adipose tissue (SSTFigure 5-1).

Muscular SystemThe temporalis muscle (4) is a major muscle of mastication

that attaches inferiorly to the mandible (SST Figure 11-8, A)

Nervous SystemThe cerebrum consists of gray matter and white matter.

The gray matter forms the cortex (3) and nuclei (SST Figure 13-9). The caudate nucleus (15) and the lentiform nucleus (14) arebasal ganglia (SST Figure 13-14). White matter nerve tracts arelocated between the gray matter. The internal capsule (7)consists of projection fibers that connect the cerebral cortex tothe thalamus and brainstem (SST Figure 13-9). The corpuscallosum consists of commisural fibers that connect the cerebralhemispheres to each other. The corpus callosum archessuperiorly and only the anterior and posterior parts (5) are cutin this section (SST Figure 13-7, A). The lateral ventricles (8) arealso arched structures cut into anterior and posterior parts (SST

Figure 13-29). Note the septum pellucidum (6) separating thetwo lateral ventricles. The thalamus (13) is a yo-yo shapedcollection of nuclei located near the midline of the brain (SSTFigure 13-7, A and B). Extensions of the dura mater form thefalx cerebri (2), which separates the cerebral hemispheres andhelps to hold the brain in place.

Skeletal SystemThe frontal sinus (1) within the frontal bone (SST Figure 7-

12). The frontal, parietal (9), and other braincase bones appearas a ring of bones when viewed in transverse section.

T1 MRI image. The skin andhypodermis appear as a white ringaround the skull bones, which appearas a black ring. There is an unusual

amount of conversion of red toyellow bone marrow. The fat contentof the yellow bone marrow appearsas white patches between the outerand inner layers of the bone (16)(Note that the frontal sinus is notvisible in the MRI). The brain graymatter is dark gray and the brainwhite matter is gray. The lateralventricles, which are filled withcerebrospinal fluid, appear black.

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Level: Superior part of thebraincase, 1 cm superior to the

supraorbital margin.SECTION 1 9

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1. Frontal sinus

2. Sclera3. Retina4. Choroid5. Orbital fat6. Temporalis muscle7. Third ventricle8. Sulcus9. Gyrus

10. Intermediate mass11. Thalamus12. Choroid plexus

13. Corpus callosum14. Lateral ventricle15. Longitudinal fissure16. Falx cerebri17. Superior sagittal sinus18. Hypodermis19. Skin20. Occipital lobe21. Subdural space22. Inferior sagittal sinus23. Lateral fissure24. Temporal lobe25. Frontal lobe

10SECTION 2

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Cardiovascular SystemThe superior sagittal sinus (17) continues inferiorly from

Section 1. The inferior sagittal sinus (22) is also cut at this level(SST Figure 21-13).

Integumentary SystemThe skin (19) of the scalp covers the loose connective tissue

of the hypodermis (18), which contains adipose tissue (SSTFigure 5-1).

Muscular SystemThe temporalis muscle (6) continues inferiorly.

Nervous SystemThe longitudinal fissure (15) separates the two cerebral

hemispheres. The lateral fissure (23) separates the temporallobe (24) from the frontal lobe (25). The occipital lobe (20) islocated posteriorly (SST Figure 13-8). The cerebral cortexconsists of gyri (9) and sulci (8). The posterior parts of thecorpus callosum (13) and lateral ventricles (14) are visible. Atthis level, the midline third ventricle (7) is also cut (SST Figure13-29). A chorid plexus ( 12) in the third ventricle producescerebrospinal fluid. The intermediate mass (10) connects thelobes of the thalamus (11) (SST Figure 13-7, B). An extension ofthe dura mater forms the falx cerebri (16). The subdural space(21) is deep to the dura mater (SST Figure 13-27, A).

The sclera (2), choroid (4), and retina (3) form the wall ofthe eye (SST Figure 15-13), which is surrounded by orbital fat(5). The retina is folded over to show the choroid.

Skeletal SystemThe frontal sinus (1) within the frontal bone (SST Figure 7-

12).

Level: Through the orbits.

T1 MRI image. The air-filled frontalsinus (1) appears black, and theorbital fat appears white. Themidline third ventricle and the

posterior horns of the lateralventricles are dark gray to black. Theposterior part of the corpus callosum,which connects the right and leftcerebral hemispheres, is visible.Immediately posterior to the corpuscallosum, the inferior sagittal sinusappears as a midline black density.

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1. Perpendicular plate of the ethmoid

bone2. Ethmoidal sinus3. Sphenoidal sinus4. Oculomotor nerve5. Basilar artery6. Cerebrum7. Midbrain (cerebral peduncle)8. Cerebral aqueduct9. Cerebellum

10. Tentorium cerebelli11. Straight sinus

12. Falx cerebri13. Superior sagittal sinus14. Temporalis muscle15. Extrinsic eye muscle (lateral rectus)16. Sclera17. Lens18. Optic nerve (MRI only)19. Pituitary gland (MRI only)20. Lateral ventricle (MRI only)

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Cardiovascular SystemThe superior sagittal sinus (13) continues inferiorly. The

inferior sagittal sinus from Section 2 becomes the straight sinus(11), which is in the junction of the tentorium cerebelli and falx

cerebri (SST Figure 21-13). The basilar artery (5) is about to jointhe cerebral arterial circle (circle of Willis) (SST Figure 21-7, B)

Muscular SystemThe temporalis muscle (14) continues inferiorly. The

extrinsic eye muscles (15) are responsible for moving the eyeball(SST Figure 15-11)

Nervous SystemThe cerebrum (6), midbrain, (7) and the cerebellum (9) are

apparent (SST Figure 13-4). The cerebral aqueduct (8) extends

inferiorly from the third ventricle (SST Figure 13-29). Withinthe transverse fissure, an extension of the dura mater called thetentorium cerebelli (10) separates the cerebrum and cerebellum.The falx cerebri (12) separates the cerebral hemispheres.

The sclera (16) and lens (17) of the eye are present on theright side (SST Figure 15-13), but only fat within the orbit isvisible on the left side. It is not unusual for a section to revealthat the eyes are not exactly level with each other. In this case,the section is not perfectly horizontal, contributing to theimpression that the eyes are not on the same level.

Skeletal SystemNote the perpendicular plate of the ethmoid bone (1) andthe air cells of the ethmoidal sinus (2) (SST Figure 7-2, F and 7-11). The sphenoidal sinus (3) within the sphenoid bone isposterior to the ethmoidal sinus (SST Figure 7-10 and 7-11).

Level: Through the orbit, 12mm below Section 2.

T1 MRI image. The air-filledethmoidal sinus appear black. TheMRI section is slightly superior to thecadaver section, demonstrating some

additional structures. MRI istypically used for viewing the softtissues of the skull because structuressuch as the optic nerves (18) show upon MRI but not CT. The white areaposterior to the ethmoidal sinus istissue, including the pituitary gland(19), located in the sella turcica of thesphenoid bone. The MRI also showsthe anterior part of the lateralventricles (20).

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1. Nasal cavity

2. Perpendicular plate of the ethmoidbone

3. Temporalis muscle4. Masseter muscle5. Sphenoidal sinus6. Internal carotid artery7. Basilar artery8. Pons9. Fourth ventricle

10. Cerebellum11. Straight sinus

12. Superior sagittal sinus13. Transverse sinus14. Occipital lobe15. Temporal lobe16. Middle nasal concha

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Cardiovascular SystemThe straight sinus (11) and transverse sinus (13) are cut

close to their junction with the superior sagittal sinus (12) (SSTFigure 21-13). The internal carotid artery (6) within the carotid

canal is visible (SST Figure 7-13 and 21-7 A and B). The basilarartery (7) is on the anterior surface of the pons (SST Figure 21-7,B)

Muscular SystemTwo muscles of mastication can be seen in this section. The

temporalis (3) is deep to the masseter (4) (SST Figure 11-6, Aand 11-8, A).

Nervous SystemA small part of the temporal (15) and occipital (14) lobes of

the cerebrum are still visible at this level, but the pons (8) andcerebellum (10) are the major brain features present (SST Figure13-4). The cerebral aqueduct from Section 3 connects to thefourth ventricle (9) (SST Figure 13-29).

Respiratory SystemThe nasal cavity (1) is visible (SST Figure 23-2).

Skeletal SystemThe middle nasal conchae (16) can be seen on either side of

the perpendicular plate of the ethmoid bone (2). The

sphenoidal sinus (5) is located posterior to the conchae (SSTFigure 7-10).

Level: Just inferior to theorbits.

T1 MRI image. Note the fourthventricle posterior to the pons andthe basilar artery anterior to the pons.The basilar artery and the two

internal carotid arteries form thepoints of a triangle. Not seen on thecadaver section, the vitreous humorwithin the eyes appears as a darkgray in the MRI.

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1. Nasal cavity

2. Maxillary sinus3. Inferior nasal concha4. Vomer5. Internal carotid artery6. Internal jugular vein7. Basilar artery8. Medulla9. Fourth Ventricle

10. Cerebellum11. Sigmoid sinus12. Mastoid air cells

13. External auditory meatus14. Lateral pterygoid muscle15. Temporalis muscle16. Masseter muscle

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Cardiovascular SystemThe internal carotid artery (5) (SST Figure 21-7, B) is located

anterior to the internal jugular vein (6) (SST Figure 21-13). Thebasilar artery (7) is found just anterior to the medulla (SST

Figures 21-7, B). The internal carotid arteries and basilar arteryjoin the cerebral arterial circle (circle of Willis) superior to thelevel of this section (SST Figure 21-7, A). Note also the sigmoidsinus (11) as it passes anteriorly to join with the internal jugularvein (SST Figure 21-13).

Muscular SystemThree muscles of mastication are visible (SST Figure 11-8).

From superficial to deep, they are the masseter (16), temporalis(15), and the lateral pterygoid (14) muscles.

Nervous SystemThis section is below the level of the cerebrum. The

medulla (8) and the lateral lobes of the cerebellum (10) can beseen (SST Figure 13-4). The fourth ventricle (9) is associatedwith the pons (see Section 4) and the superior half of themedulla. In the inferior half of the medulla, the fourth ventriclenarrows to form the central canal, which continues inferiorlyinto the spinal cord (SST Figure 13-29).

Respiratory SystemThe nasal cavity (1) (SST Figure 23-2).

Skeletal SystemThe vomer (4) forms the inferior part of the nasal septum,

which divides the nasal cavity (1). The inferior nasal conchae(3) are located lateral to the vomer (SST Figure 7-10). Themaxillary sinuses (2) are the largest paranasal sinuses (SSTFigure 7-11). The external auditory meatus (13) extends into thetemporal bone (SST Figure 15-23), and the mastoid air cells (12)are visible within the mastoid process of the temporal bone(SST Figure 7-5).

Level: Through the nasalcavity, 12 mm below the orbits.

T1 MRI image. The air-filledmaxillary sinuses appear black, asdoes the air within the nasal cavityon either side of the nasal septum.

The muscles of mastication appeargray, and they are surrounded by fatand connective tissue, which appearswhite. The external auditory meatus,mastoid air cells, and sigmoid sinusappear black.

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1. Oral cavity

2. Tongue3. Uvula4. Collapsed connection between the

nasopharynx and oropharynx5. Medial pterygoid muscle6. Ramus of mandible7. Masseter muscle8. Parotid salivary gland9. Internal carotid artery

10. Internal jugular vein11. Vertebral artery

12. Dens of axis (second cervical vertebra)13. Atlas (first cervical vertebra)14. Spinal cord15. Subarachnoid space16. Cerebellum17. Occipital bone18. Meninges19. Denticulate ligament20. Mastoid process of temporal bone21. Oropharynx (MRI only)

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Cardiovascular SystemThe internal carotid arteries (9) and the vertebral arteries

(11) supply the brain with blood (SST Figure 21-7, A and B).Blood from the brain enters venous sinuses (see more superior

sections) and exits the skull through the internal jugular veins(10) (SST Figure 21-13). The internal jugular vein is larger thanthe internal carotid artery.

Digestive SystemThe oral cavity (1) contains the tongue (2), and the parotid

glands (8) are lateral to the mandibular rami (SST Figure 24-7,A).

Muscular SystemThe masseter (7) continues inferiorly from Section 5. The

medial pterygoid (5) attaches to the medial surface of themandible (SST Figure 11-8, B). The tongue (2) is within the oralcavity (SST Figure 11-10).

Nervous SystemThe spinal cord (14) and cerebellum (16) (SST Figure 13-8,

B). The spinal cord is surrounded by the meninges (18) and thesubarachnoid space (15). Denticulate ligaments (19) hold thespinal cord in place (SST Figure 13-28, B).

Respiratory System

The uvula (3) of the soft palate has collapsed the connection(4) between the nasopharynx and the oropharynx (SST Figure23-2, A). In life, closing this connection prevents swallowedmaterials from entering the nasopharynx.

Skeletal SystemThe ramus of the mandible (6), the mastoid process (20) of

the temporal bone, and the inferior part of the occipital bone(17) are cut (SST Figure 7-5). The atlas (13) and dens (12) of theaxis are also sectioned (SST Figure 7-18, A and B).

Level: Through the oral cavity.

T1 MRI image. The oral cavity (1)contains the tongue (2). Posteriorly,the uvula (3) of the soft palateextends into the oropharynx (21). In

the cadaver section, the connection(4) between the nasopharynx andoropharynx is collapsed. Use theramus of the mandible (6) as alandmark. The masseter is lateral tothe ramus, and the medial pterygoidis medial to the ramus.

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1. Suprahyoid muscle (geniohyoid)

2. Extrinsic tongue muscle (genioglossus)3. Submandibular salivary gland4. Tongue5. Epiglottis6. Laryngopharynx7. External carotid artery8. Internal jugular vein9. External jugular vein

10. Sternocleidomastoid muscle11. Internal carotid artery12. Vertebral artery

13. Spinal nerve14. Spinal cord15. Trapezius muscle16. Dura mater17. Transverse process of vertebra18. Body of cervical vertebra19. Mandible (CT only)20. Vallecula (CT only)

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Cardiovascular SystemThe external carotid arteries (7) supply the neck, throat, and

mouth (SST Figure 21-7, A). The external jugular veins (9) drainthe superficial surface of the head and neck (SST Figure 21-14).

At this level, the external carotid artery is anterior and medialto the internal carotid artery (11). Note the arterioscleroticplaque within the left internal carotid artery. Thesternocleidomastoid muscle separates the internal jugular vein(8) from the more superficial external jugular vein. Thevertebral arteries (12) are within the transverse foramina of thecervical vertebra (SST Figure 21-7, A).

Digestive SystemPart of the submandibular salivary glands (3) are located

inferior to the mandible (SST Figure 24-7, A). The

laryngopharynx (6) connects inferiorly to the esophagus (SSTFigure 23-2, A).

Muscular SystemA suprahyoid muscle (geniohyoid) (1) is cut between its

attachment to the hyoid bone and mandible (SST Figure 11-10).An extrinsic tongue muscle (genioglossus) (2) attaches to the

base of the tongue (4) (SST Figure 23-2, A). Thesternocleidomastoid muscle (10), the trapezius (15), and otherneck muscles are also evident (SST Figure 11-4).

Nervous SystemA spinal nerve (13) exits the spinal cord (14) (SST Figure 14-2). The dura mater (16) surrounds the spinal cord (SST Figure13-28).

Respiratory SystemThe epiglottis (5) forms the superior part of the larynx (SST

Figure 23-2, A and 23-3).

Skeletal SystemThe body (18) and transverse processes (17) of a cervical

vertebra (SST Figure 7-18, C).

Level: Through C4. The neck,inferior to the mandible.

CT image. In CT images, fat appearsdark gray to black, whereas bone andcartilage appear white. Air-filledspaces, such as within the laryngo-pharynx, appear black. Contrastmedia within the blood vesselsappears white. An outer white orgray border is sometimes seenaround a CT section. It is an artifactproduced at air-tissue interfaces. Aportion of the mandible (19) and thevallecula (20) are visible in the CT,but not in the cadaver section. Thevallecula is a depression between theepiglottis and the tongue.

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1. Thyroid cartilage of larynx2. Vocal cords3. Laryngeal cavity4. Arytenoid cartilage of larynx5. Cricoid cartilage of larynx6. Laryngopharynx

7. Sternocleidomastoid muscle8. Common carotid artery9. Internal jugular vein

10. External jugular vein11. Vertebral artery12. Spinal nerve

13. Gray matter of spinal cord14. White matter of spinal cord15. Spinous process of vertebra16. Trapezius muscle17. Vertebral foramen18. Body of cervical vertebra

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Level: Through C6. Theneck, at its junction with the

shoulders.

CT images. A classic view of thelarynx, showing the anterior v-shaped thryoid cartilage and theposterior cricoid cartilage. The air-filled laryngeal cavity is black, withsmall portions of the gray-coloredvocal cords located laterally. Thegray-colored spinal cord is within thevertebral foramen.

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SECTION 8


Cardiovascular SystemInternal (9) and external jugular (10) veins are present (SST

Figure 21-14). The common carotid artery (8) is cut inferior tothe bifurcation of the common carotid into the internal carotid

and external carotid arteries (see Section 7). The vertebralarteries (11) are present (SST Figure 21-7, A). The internal

jugular vein lies between the external jugular vein and thecommon carotid artery.

Digestive SystemThe laryngopharynx (6) is evident immediately posterior to

the larynx (SST Figure 23-2).

Muscular SystemThe sternocleidomastoid muscle (7), the trapezius (16), and

other neck muscles are evident (SST Figure 11-4).

Nervous SystemThe spinal cord continues inferiorly. Note the internal gray

matter (13) and the outer white matter nerve tracts (14) of thespinal cord (SST Figure 13-19). Spinal nerves (12) are cut nextto the cervical vertebra.

Respiratory SystemSeveral of the cartilages forming the larynx are present (SST

Figure 23-2, A and 23-3). The inferior part of the thyroid

cartilage (1) and part of the cricoid (5) and arytenoid cartilages(4) are visible. The vocal cords (2), or vocal folds, are separatedby the laryngeal cavity (3) (SST Figure 23-4).

Skeletal SystemThe vertebral foramen (17) is occupied by the spinal cord

and meninges (SST Figure 7-15). Note the bifid spinous process(15) and the body (18) of the cervical vertebra (SST Figure 7-18,C).

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1. Trachea (C-shaped cartilage)2. Cavity of trachea3. Thyroid gland4. Sternocleidomastoid muscle5. Esophagus6. Common carotid artery7. Internal jugular vein

8. External jugular vein9. Vertebral artery

10. Body of cervical vertebrae11. Spinal cord12. Spinal nerve13. Coracoid process of scapula14. Joint capsule

15. Acromion process of scapula16. Trapezius muscle17. Spine of scapula18. Deltoid muscle19. Head of humerus20. Clavicle

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Level: Through C7. The neckand superior aspect of the

shoulders.

CT image. The gray-colored thyroidgland is located lateral to the air-filled trachea, which appears black.The gray-colored tissue posterior tothe trachea is the esophagus.Immediately posterior to theesophagus is the body of thevertebrae. In addition to thevertebra, other white-colored bonesare apparent. Also note the manygray-colored muscles. The streakedappearance is an artifact producedbecause the computer has difficultydistinguishing between bone andsurrounding soft tissue.

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SECTION 9


Cardiovascular SystemThe common carotid arteries (6) and the vertebral arteries

(9) extend superiorly (SST Figure 21-7, A), whereas the internaljugular (7) and external jugular (8) veins descend (SST Figure

21-14).

Digestive SystemThe esophagus (5) is located posterior to the trachea and

anterior to the vertebral body (SST Figure 23-2). The esophaguscontinues inferiorly (SST Figure 24-1).

Endocrine SystemThe lobes of the thyroid gland (3) are located beside the

trachea (SST Figure 18-7, A).

Muscular SystemThe sternocleidomastoid (4), trapezius (16), deltoid (18) and

other muscles are visible in this section (SST Figures 11-3 and11-4).

Nervous SystemThe spinal cord (11) continues inferiorly. Spinal nerves (12)

extend away from the vertebra.

Respiratory SystemThe trachea is anterior to the esophagus. Note the C-

shaped cartilage (1) of the tracheal wall and the cavity of thetrachea (2) (SST Figure 23-3 and 23-5, A).

Skeletal SystemThe vertebral body (10) is posterior to the esophagus. On

the right side, the head of the humerus (19), the spine (17) andthe coracoid process (13) of the scapula, and the clavicle (20) arecut. On the left side, the acromion process (15), coracoidprocess (13), and superior part of the shoulder joint capsule (14)are cut (SST Figure 7-1 and 7-21).

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1. Manubrium of sternum2. Articular disk3. Clavicle4. Right brachiocephalic vein5. Brachiocephalic artery6. Left brachiocephalic vein7. Left common carotid artery8. Left subclavian artery9. Axillary vein

10. Axillary artery11. Trachea12. Esophagus13. Body of vertebra14. Spinal cord15. Left lung16. Rib17. Scapula18. Head of humerus

19. Rotator cuff muscles20. Erector spinae muscles21. Trapezius muscle22. Deltoid muscle23. Shaft of humerus24. Pectoralis major muscle25. Pectoralis minor muscle

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Level: Through T3. Superiorpart of the thoracic cavity.

CT image. From anterior to posterior,note the relationship between thetrachea, esophagus, and body of thevertebrae. Located around thetrachea in a clockwise direction arethe brachiocephalic, left commoncarotid, and left subclavian arteries.The left brachiocephalic vein hasbeen cut in two places as it crossesover to the right side of the body tojoin the superior vena cava. Onesection through the leftbrachiocephalic vein appearselongated because it has been cutmore longitudinally.

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SECTION 10


Cardiovascular SystemThe brachiocephalic artery (5), left common carotid artery

(7), and left subclavian artery (8) have just branched off theaortic arch (SST Figure 21-9, A). The right (4) and left (6)

brachiocephalic veins are descending to join the superior venacava (SST Figure 21-16). The axillary artery (10) and vein (9) arepresent (SST Figures 21-8 and 21-15).

Digestive SystemThe esophagus (12) continues inferiorly (SST Figure 24-1).

Muscular SystemThe pectoralis major (24) (SST Figure 11-20, A) and

pectoralis minor (25) (SST Figure 11-19, B) are part of theanterior chest. The deltoid (22) and trapezius (21) muscles

continue inferiorly (SST Figure 11-3). Note the rotator cuffmuscles (19) on both sides of the scapula (SST Figure 11-20, Band 11-21). Erector spinae muscles (20) are along the midline ofthe back (SST Figure 11-13).

Nervous SystemThe spinal cord (14) continues inferiorly.

Respiratory SystemThe trachea (11) continues inferiorly from Section 9. The

apical lobe (15) of each lung is present (SST Figure 23-6).

Skeletal SystemParts of the thoracic cage (SST Figure 7-19, A) are present:

the manubrium of the sternum (1), ribs (16), and a thoracicvertebra (13). Because the ribs slant anteriorly, more than onerib can be cut at the same time. The manubrium is separatedfrom each clavicle (3) by an articular disk (2) (SST Table 8-1).On the left side, the scapula (17) articulates with the head of thehumerus (18). On the right side, the shaft of the humerus (23)has been cut (SST Figure 8-9, B).

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1. Manubrium of sternum2. Superior vena cava3. Brachiocephalic artery4. Left common carotid artery5. Left subclavian artery6. Aortic arch7. Axillary vein

8. Axillary artery9. Humerus

10. Scapula11. Rib12. Left lung13. Oblique fissure14. Pleural cavity

15. Trachea16. Esophagus17. Body of vertebra18. Spinal cord19. Teres major muscle

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Level: Through T4. Thorax,through the lungs and aortic

arch.

CT image. Note the relationshipbetween the trachea, esophagus, andbody of vertebrae. The aortic archhas been cut longitudinally andappears white because it containscontrast media. The superior venacava is located to the right of theaortic arch. The air-filled lungsappear black. The white dots withinthe lungs are pulmonary vesselscontaining contrast media. Note theribs attaching to the transverseprocesses and body of the vertebra.

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SECTION 11


Cardiovascular SystemThe aortic arch (6) is cut, revealing the openings to the

brachiocephalic (3), left common carotid (4), and left subclavian(5) arteries, which project superiorly (SST Figure 21-9. A). The

brachiocephalic veins from the previous section have joined toform the superior vena cava (2) (SST Figure 21-16) The axillaryartery (8) and vein (7) are more laterally located at this levelthan in the previous section (SST Figures 21-8 and 21-15).

Digestive SystemThe esophagus (16) continues inferiorly.

Muscular SystemThe teres major (19) muscle is present (SST Figure 11-20, B).

See Section 10 for other muscles.


Respiratory SystemThe trachea (15) continues inferiorly. Because the lungs are

cone shaped, the cut through this part of the lungs is larger thanin the previous section. Each lung is surrounded by a pleuralcavity (14) within the thoracic cavity (SST Figure 23-7). Notethe oblique fissure (13), which divides the left lung (12) intolobes (SST Figure 23-5).

Skeletal SystemThe manubrium of the sternum (1), the ribs (11), and a

thoracic vertebra (17) form the boundary of the thoracic cavity.Both scapulae (10) and both humerus bones (9) are also present(SST Figure 7-19, A).

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2

6

15


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1. Body of sternum2. Adipose tissue of mediastinum3. Pericardial cavity4. Superior vena cava5. Ascending aorta6. Pulmonary trunk7. Right pulmonary artery8. Left pulmonary artery9. Descending (thoracic) aorta

10. Azygos vein11. Right primary bronchus12. Left primary bronchus13. Esophagus14. Body of vertebra15. Spinal cord16. Spinal nerve17. Left lung18. Oblique fissure

19. Rib20. Scapula21. Humerus22. Right lung23. Brachial veins24. Brachial artery25. Basilic vein26. Trachea dividing to form right and

left primary bronchi (CT only)

SECTION 12 30

1

2

5 6

10

24

23 21

20

18

19

11 12

16

14

9

7

13

8

15

2221

4

3

17

25


24/55

Level: Through T6. Thorax,through the lungs and

pulmonary trunk.

CT image. A classic picture of thepulmonary trunk dividing to formthe pulmonary arteries. Togetherthey form an inverted y-shapedstructure. The ascending aorta (5) isalways anterior to the descendingaorta (9), which is located just to theleft of the midline along the vertebralbody. The trachea (26), whichappears black, is dividing to form theright and left primary bronchi.Inferior to this point, the esophagusis located next to the descendingaorta.

R L

SECTION 12


Cardiovascular SystemThe ascending aorta (5) and descending (thoracic) aorta (9)

are cut inferior to the aortic arch. The ascending aorta projectsto the right upon leaving the left ventricle. The superior vena

cava (4) lies next to the ascending aorta. Note the bifurcation ofthe pulmonary trunk (6) into the right (7) and left (8)pulmonary arteries. The pulmonary trunk projects to the leftupon leaving the right ventricle. See SST Figure 20-6 for therelative location of these vessels. The superior part of thepericardial cavity (3) is visible (SST Figure 20-4). The brachialarteries (24) supply blood to the upper limbs and the basilic (25)and brachial veins (23) return blood (SST Figures 21-8 and 21-15). At this level, the basilic and brachial veins oftenanastomose and are difficult to distinguish. The azygos vein(10), located just anterior to the vertebral body, continuessuperiorly to join the superior vena cava (SST Figure 21-16).


Muscular SystemSee the muscles listed in the previous section. Muscles of

the arm surround the humerus.

Nervous SystemThe spinal cord (15) continues inferiorly. Note the spinal

nerves (16) exiting the spinal cord (SST Figure 14-2).

Respiratory SystemThe right lung (22) is larger than the left lung (17). The

oblique fissure (18) separates the lobes of the left lung. Right(11) and left (12) primary bronchi are located inferior to theirbifurcation from the trachea (SST Figure 23-5, A).

Skeletal SystemThe scapula (20) and humerus (21) are located bilaterally;

the body of the sternum (1) is anterior to the mediastinum (2).Note the thoracic vertebra (14) and ribs (19) (SST Figure7-19, A). 31

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1. Body of sternum2. Pericardial cavity3. Pericardial sac4. Top of right atrium (cut)5. Right atrium6. Superior vena cava7. Right ventricle8. Interventricular septum9. Left ventricle

10. Left atrium11. Interatrial septum12. Pulmonary veins13. Azygos vein14. Descending (thoracic) aorta15. Esophagus16. Bronchi17. Left lung18. Body of vertebra

19. Spinal cord20. Trapezius muscle21. Latissimus dorsi muscle22. Serratus anterior muscle23. Pleural cavity24. Base of right lung25. Oblique fissure26. Rib

SECTION 13 32

1

2

3

4

5

6

7

8

9

18

19

10

11

1314

15

16

17

20

21

22

23

24

25

26

12 25


26/55

Level: Through T8. Thorax,through the lungs and heart.

CT image. From anterior to posterior,the esophagus (15), descending aorta(14), and body of vertebra are visible.The azygos vein (13) is located to theright of the descending aorta. Theheart appears white because it isfilled with contrast media. The fourchambers of the heart are visible.The interventricular septum (8) andthe interatrial septum (11), whichseparate the left and right sides of theheart, appear gray. A few pulmonaryblood vessels, also filled with contrastmedia, appear as white spots withinthe lungs.

R L

SECTION 13


Cardiovascular SystemThe pericardial sac (3) and pericardial cavity (2) surround

the heart (SST Figure 20-4). The superior vena cava (6) entersthe right atrium (5) (SST Figure 20-8). The top of the right

atrium (4) has been cut, so it appears to be an opening.Pulmonary veins (12) enter the left atrium (10), which isseparated from the right atrium by the interatrial septum (11).The interventricular septum (8) separates the right ventricle (7)from the left ventricle (9). Compare the difference in thicknessof the walls of the atria, right ventricle, and left ventricle (SSTFigure 20-8). The descending (thoracic) aorta (14) continuesinferiorly (SST Figure 21-9, B), and the azygos vein (13)continues superiorly (SST Figure 21-16).


Muscular SystemThe latissimus dorsi (21), serratus anterior (22), and trapezius(20) (SST Figure 11-3).


Respiratory SystemA pleural cavity (23) surrounds each lung (SST Figure 23-7)

Oblique fissures (25) divide the left (17) and right (24) lungsinto lobes, and bronchi (16) are visible within the lungs (SSTFigure 23-6). The concave base of the right lung has been cut,leaving a shallow basin (24). The base of the right lung is at ahigher level than the base of the left lung because of theposition of the liver on the right side.

Skeletal SystemThoracic vertebra (18), ribs (26), and the body of the

sternum (1) are present in this section (SST Figure 7-19, A).

33

11

1314

15

78

9


27/55

1. Body of sternum2. Pericardial sac3. Pericardial cavity4. Right ventricle5. Interventricular septum6. Left ventricle7. Right atrium8. Inferior vena cava

9. Coronary sinus10. Descending (thoracic) aorta11. Azygos vein12. Esophagus13. Body of vertebra14. Spinal cord15. Left lung16. Pleural cavity

17. Rib18. Right lung19. Diaphragm20. Liver21. Bony spur (CT only)

SECTION 14 34

1

4

5

6

16

17

15

1011

12

13

1418

19

20

7

8 9

32


28/55

Level: Through T10. Thorax,through the lungs, heart, and

superior part of the liver.

CT image. From anterior to posterior,the esophagus, descending aorta, andbody of the vertebra are visible. Theazygos vein is located to the right ofthe descending aorta. A bony spur

(21) protrudes from the right side ofthe vertebral body. Fat within thecoronary sulcus appears as a blackslash separating the left atrium fromthe left ventricle.

R L

SECTION 14


Cardiovascular SystemThe pericardial sac (2) and pericardial cavity (3) surround

the heart (SST Figure 20-4). Note the fat associated with thepericardial sac and the surface of the heart. The right ventricle

(4) is mostly filled with blood. The interventricular septum (5)and the wall of the left ventricle surround a small part of theleft ventricular chamber (6). The blood-filled inferior vena cava(8) and coronary sinus (9) enter the right atrium (7) (SST Figure20-7, A). The descending aorta (10) continues inferiorly, and theazygos vein (11) continues superiorly (SST Figure 21-16).

Digestive SystemThe esophagus (12) continues inferiorly. The right lobe of

the liver (20) has been cut (SST Figure 24-12, A). It is in contactwith the cut diaphragm,

Muscular SystemPart of the diaphragm (19) is between the right lung and the

liver (SST page 10). See previous section for other muscles.


Respiratory SystemA pleural cavity (16) surrounds each lung (SST Figure 23-7).

The right side of the dome-shaped diaphragm has been cut (SST

Figure 23-8). This portion of the diaphragm is between the liverand the right lung. The right (18) and left (15) lungs superior tothe rest of the diaphragm are also visible.

Skeletal SystemThoracic vertebra (13), ribs (17), and the body of the

sternum (1) are present in this section (SST Figure 7-19, A).

35

21

20


29/55

1. Xiphoid process of sternum2. Costal cartilage3. Transverse colon4. Descending colon5. Stomach6. Rib7. Intercostal muscles8. Peritoneal cavity9. Pleural cavity

10. Left lung

11. Descending (abdominal) aorta12. Azygos vein13. Inferior vena cava14. Hepatic portal vein15. Hepatic vein16. Esophagus17. Body of vertebra18. Spinal cord19. Right lung20. Diaphragm

21. Right lobe of liver22. Ascending colon23. Gallbladder24. Quadrate lobe of liver25. Falciform ligament26. Left lobe of liver27. Ligamentum venosum28. Caudate lobe of liver29. Spleen (CT only)

SECTION 15 36

12

3

4

56

8

9

7

10

1112

13

15

16

17

18

19

21

20

2223

28

24

14

2625

27

3


30/55

Level: Through T11.Abdominal cavity, through the

stomach and liver.

CT image. Oral and intravenouscontrast media enhance the GI tractand blood vessels. There isconsiderable variation in the locationof organs within the abdominal

cavity. The CT images in Sections 15-18 show the major organs, but are nota perfect match to the cadaversections. Do not confuse the inferiorleft lung (10) in the cadaver sectionwith the spleen (29) (SST Figure 22-1and 22-5) in the CT. Also, the colon(3, 4, and 22) is visible in the cadaversection, but not in the CT.

R L

SECTION 15


Cardiovascular SystemThe descending (abdominal) aorta (11) and inferior vena

cava (13) are next to the esophagus (SST Figure 21-17). Theazygos vein (12) continues superiorly (SST Figure 21-16). The

hepatic portal vein (14) carries blood to the liver fromabdominal organs. One of the hepatic veins (15) empties intothe inferior vena cava (SST Figure 21-18). Also note theligamentum venosum (27), which is a remnant of the fetalductus venosus (SST Figure 29-19, B).

Digestive SystemThe esophagus (16) joins the stomach (5) (SST Figure 24-8,

A). The ascending (22), transverse (3), and descending (4)colons are present (SST Figure 24-14, A). The ascending colon isusually located just inferior to the liver. In this person, theascending colon is more superior and anterior to the liver. Thetransverse colon is cut twice because it hangs inferiorly betweenthe ascending and descending colons (SST Figure 24-14, B). Thefalciform ligament (25) is between the left (26) and quadrate (24)lobes of the liver. The right (21) and caudate (28) liver lobes arepresent (Turn SST Figure 24-12, B upside down to see theserelationships). The gallbladder (23) is on the anterior surface ofthe liver (SST Figure 24-13). The space between abdominalorgans is the peritoneal cavity (8) (SST Figure 1-15).

Muscular SystemThe inferior circumference of the diaphragm (20) near its

attachment to the thoracic wall (SST Figure 23-8). Note theintercostal muscles (7) between the ribs (6) (SST Figure 11-14).


Respiratory SystemThe left (10) and right (19) lungs and the pleural cavity (9).

Skeletal SystemVertebra (17), ribs (6), xiphoid process (1) of the sternum,

and costal cartilages (2) (SST Figure 7-19, A).37

5

13 16

29


31/55

1. Linea alba2. Rectus abdominis3. Costal cartilage4. Body of stomach5. Transverse colon6. Descending colon7. Rib8. Spleen9. Peritoneal cavity

10. Diaphragm11. Pleural cavity12. Branches of splenic artery and vein13. Descending (abdominal) aorta14. Azygos vein15. Inferior vena cava16. Branch of hepatic portal vein17. Caudate lobe of liver18. Body of vertebra

19. Spinal cord20. Right lobe of liver21. Ascending colon22. Lumen of gallbladder23. Superior part of duodenum24. Kidney (CT only)25. Pancreas (CT only)26. Adrenal gland (CT only)27. Falciform ligament (CT only)

SECTION 16 38

1 23

4 5

6

12

8

7

9

11

14

18

10

19

17

15

10

13

16

20

22

21

5

23


32/55

Level: Through T12.Abdominal cavity, through the

stomach, liver, and spleen.

CT image. The stomach, transversecolon (5), descending colon (6), andspleen (8) are seen in both thecadaver and CT. Because the personis lying down, the contrast medium

(white) in the stomach forms a levelinterface with the air (black) in thestomach. The liver in this CT is morelike the liver in cadaver Section 15,including the falciform ligament (27)and the hepatic portal vein (16). Thepancreas (25) and adrenal gland (26)in this CT can be seen in cadaverSection 17. The kidney (24) in this CTcan be seen in cadaver Section 18.

R L

SECTION 16


Cardiovascular SystemThe descending (abdominal) aorta (13) extends inferiorly,

and the inferior vena cava extends superiorly (15). The azygosvein (14) continues superiorly. Branches of the splenic artery

and vein (12) are located next to the spleen. A branch of thehepatic portal vein (16) carries blood from abdominal organsinto the liver.

Digestive SystemThe ascending colon (21) continues superiorly, and the

descending colon continues inferiorly (6). The transverse colon(5) extends inferiorly on each side of the body of the stomach(4), which also extends inferiorly. The superior part of theduodenum (23) projects upward from Section 17 and extendstoward the gallbladder (22), the lumen of which is clearlyvisible. The superior part of the duodenum then turnsinferiorly to form the descending part of the duodenum, whichcan be seen Section 17 (SST Figure 24-9). The right (20) andcaudate (17) lobes of the liver are still present. The spacebetween abdominal organs is the peritoneal cavity (9) (SSTFigure 1-15).

Lymphatic SystemThe spleen (8) (SST Figures 22-1 and 22-5, A).

Muscular SystemThe rectus abdominis (2) and linea alba (1) continue

inferiorly (SST Figure 11-15). The diaphragm (10) extendsinferiorly to attach to the lumbar vertebrae.


Respiratory SystemThe inferior part of the pleural cavity (11).

Skeletal System

A lumbar vertebra (18), ribs (7), and costal cartilages(3) are present (SST Fig 7-19, A). 39

24

1525

16

27

8

5

6

26


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1. Linea alba2. Rectus abdominis muscle3. Stomach (pylorus)4. Transverse colon5. Superior part of duodenum6. Descending part of duodenum7. Head of pancreas8. Body of pancreas9. Tail of pancreas

10. Descending colon

11. Hepatic portal vein

12. Common hepatic artery13. Splenic artery14. Inferior vena cava15. Descending (abdominal) aorta16. Left adrenal gland17. Spleen18. Rib19. Perirenal fat20. Body of vertebra21. Dura mater

22. Subarachnoid space

23. Spinal cord24. Right adrenal gland25. Diaphragm26. Kidney27. Liver28. Ascending colon29. Celiac trunk (CT only)30. Splenic vein (CT only)31. Gallbladder (CT only)

SECTION 17 40

1 2

13

4

3

79

10

16

17

1819

15

22

20

2123

14

24

25

26

4

27

11

28126

8

5


34/55

Level: Through L1.Abdominal cavity, through the

stomach, pancreas, and spleen.

CT image. The pyloric region of thestomach joins the superior part of theduodenum in both the CT andcadaver sections. In the CT, the celiactrunk (29) branches from the aorta

and gives rise to the splenic artery(13). The splenic vein (30) isposterior to the splenic artery. Thekidneys (26) in this CT can be seen incadaver Section 18, and thegallbladder (31) in Section 16.

R L

SECTION 17


Cardiovascular SystemThe descending (abdominal) aorta (15) and the inferior vena

cava (14) are next to the vertebra. The hepatic portal vein (11)(SST Figure 21-18) and common hepatic artery (12) (SST Figure

21-10, A) supply the liver. The splenic artery (13) extends alongthe pancreas.

Digestive SystemThe pylorus of the stomach (3) joins the superior part of the

duodenum (5), which projects upward (SST Figure 24-8, A).The superior part of the duodenum then turns inferiorly toform the descending part of the duodenum (6) (SST Figure 24-9). The pancreas consists of a head (7), located in the curvatureof the duodenum, a body (8), and a tail (9) (SST Figure 24-10,A). The tail of the pancreas extends to the spleen (SST Figure24-13). Note the ascending (28), transverse (4), and descending(10) colons (SST Figure 24-14, A), and the liver (27).

Endocrine SystemThe right (24) and left (16) adrenal glands are superior to

the kidneys (SST Figure 18-12, A) in Section 18.

Lymphatic SystemThe spleen (17) (SST Figures 22-1 and 22-5, A).

Muscular System

Rectus abdominis (2), linea alba (1), and diaphragm (25).

Nervous SystemThe spinal cord (23) extends inferiorly. The dura mater (21)

and subarachnoid space (22) are visible (SST Figure 13-28, B).

Skeletal SystemLumbar vertebra (20) and ribs (18) (SST Fig 7-19, A).

Urinary SystemNote the perirenal fat (19). The top of the right kidney (26)

is barely cut (SST Figure 26-1). 41

11

13

14

26

31

26

29

30


35/55

1. Transverse colon2. Head of pancreas3. Body of pancreas4. Tail of pancreas5. Descending colon6. Superior mesenteric vein7. Right renal vein8. Inferior vena cava9. Left renal vein

10. Superior mesenteric artery

11. Right renal artery12. Descending (abdominal) aorta13. Left renal artery14. Cyst15. Left kidney16. Spleen17. Rib18. Perirenal fat19. Body of vertebra20. Cauda equina

21. Right kidney22. Renal pelvis23. Renal calyx24. Peritoneal cavity25. Ascending colon26. Descending part of duodenum27. Liver (CT only)28. Ureter (CT only)29. Jejunum (CT only)

SECTION 18 42

1

5

42

15

11 13

3

10

14

16

17

18

12

19

20

8

7

21

2223

24

25 26

6

9

1


36/55

Level: Through L2.Abdominal cavity through the

colon, pancreas, and kidneys.

CT image. The left and right renalveins enter the inferior vena cava (8).Note the contrast medium in the leftureter (28). The contrast medium,which is injected into the blood in

order to visualize the blood vessels, isremoved from the blood by thekidneys. In the CT, the inferior partof the liver (27) is visible, much as incadaver Section 17. The CT alsoshows more small intestine (29),which is more like cadaver Section19. There is a cyst in the right kidney(dark area).

R L

SECTION 18


Cardiovascular SystemThe descending (abdominal) aorta (12) gives rise to the

superior mesenteric artery (10) and the right (11) and left (13)renal arteries (SST Figure 21-9, A). The right (7) and left (9)renal veins enter the inferior vena cava (8) (SST Figure 21-17),The superior mesenteric vein (6) extends superiorly (SST Figure21-18).

Digestive SystemThe ascending (25), transverse (1), and descending (5)

colons are present (SST Figure 24-14, A). The transverse colonhas been obliquely cut. The head (2), body (3), and tail (4) ofthe pancreas (3) and the descending part of the duodenum (26)are also present (SST Figure 24-10, A). The peritoneal cavity(24) is visible (SST Figure 1-15)

Muscular SystemSee previous section for muscles.

Lymphatic SystemA small portion of the spleen (16) is present posterolaterally

on the left side (SST Figure 22-1).

Nervous SystemThe cauda equina (20) arises from the spinal cord and

extends inferiorly through the vertebral canal (SST Figure 13-18).

Skeletal SystemA lumbar vertebra (19) and ribs (17) are present (Fig 7-19,

A).

Urinary SystemIn the right kidney (21), renal calyces (23) and the renal

pelvis (22) are evident (SST Figure 26-2). Note the cyst (14) inthe left kidney (15), and the thick periremal fat (18) surroundingboth kidneys.

43

1

2

2627

8

28

2910

5

6


37/55

1. Linea alba2. Rectus abdominis3. Transverse colon4. Descending part of duodenum5. Horizontal part of duodenum6. Ascending part of duodenum7. Superior loop of jejunum8. Jejunum

9. Descending colon10. Cyst11. Left ureter12. Left kidney13. Descending (abdominal) aorta14. Inferior vena cava15. Intervertebral disk16. Vertebral canal

17. Erector spinae muscles18. Psoas major muscle19. Right ureter20. Perirenal fat21. Lateral abdominal wall22. Ascending colon23. Ileum

SECTION 19 44

1

7

68

910

1119

12

1314

15

16

17

18

20

421

22 23

3

2

5


38/55

Level: Intervertebral diskbetween L2 and L3. The kidney,

colon, and small intestine.

CT image. The psoas major muscles(18) are landmarks used to find thesmaller ureters (11 and 19), which arefilled with intravenous contrastmedium, . The oral contrast medium

used to enhance the digestive tracthas been moved inferiorly byperistalsis. Many loops of the ileumare visible in the CT, but only oneloop of the ileum is visible in thecadaver section. Note that the air-filled spaces of the digestive tractappear black.

R L

SECTION 19


Cardiovascular SystemThe descending (abdominal) aorta (13) continues inferiorly

and the inferior vena cava (14) continues superiorly.

Digestive SystemThe descending part of the duodenum (4) turns to the leftto form the horizontal part of the duodenum (5). Thehorizontal part extends to the descending aorta and turnssuperiorly to form the ascending part of the duodenum (6),which projects superiorly to join the jejunum. The jejunum (8)then extends inferiorly (SST Figure 24-9 and 24-10, A). A loopof the jejunum (7) from a lower level also extends into thissection. Note the extensive circular folds in the duodenum (SSTFigure 24-11, A). The ascending (22), transverse (3), anddescending (9) colons are present. Part of the ileum (23) is seennext to the ascending colon (SST Figure 24-9).

Muscular SystemThe linea alba (1), rectus abdominis (2) and lateral

abdominal wall muscles (21) are present (SST Figure 11-15).The psoas major (18) (SST Figure 11-29, A) and the erectorspinae (17) (SST Figure 11-13) are visible.

Nervous SystemThe cauda equina should be present, but is missing from

the vertebral canal of this section.

Skeletal SystemThis section is inferior to the ribs. An intervertebral disk

(15) and the vertebral canal (16) are cut (SST Figure 7-15, A)

Urinary SystemThe left kidney (12) is visible, but this section is inferior to

the right kidney. Only the perirenal fat (20) is seen on the right.Typically the right kidney is lower than the left (SST Figure 26-1, A), but in this individual the opposite is true. The left (11)and right (19) ureters descend toward the urinary bladder. Acyst (10) is located in the left renal fat pad.

45

11 12

23

5

22

8

18

19

3

9


39/55

1. Mesentery proper2. Peritoneal cavity3. Small intestine4. Descending colon5. Ureter6. Ilium

7. Sacral canal8. Vertebral canal9. Body of vertebra

10. Left common iliac artery11. Left common iliac vein12. Right common iliac artery

13. Right common iliac vein14. Psoas major muscle15. Iliacus muscle16. Gluteus medius muscle17. Cecum (CT only)18. Ileum (CT only)

SECTION 20 46

1

3

4

5

6

9

1011

7

8

13

12

14

15

16

2


40/55

Level: Body of L5 and thesuperior part of the ilium. The

inferior abdominal cavity.

CT image. The contrast-filled ureters(5) descend inferiorly with the psoasmajor muscles (14). The commoniliac arteries branch off thedescending aorta and extend

inferiorly, whereas the common iliacveins extend superiorly to join theinferior vena cava. Seen only in theCT, the ileum (18) joins the cecum(17).

R L

SECTION 20


Cardiovascular SystemThe descending (abdominal) aorta has divided to form the

left (10) and right (12) common iliac arteries (SST Figure 21-9,A). Note the atherosclerotic plaque associated with the iliacarteries. The left (11) and right (13) common iliac veins areinferior to the location where they join to form the inferior venacava (SST Figure 21-17).

Digestive SystemThe descending (4) colon is present, but this section is

inferior to the transverse colon (SST Figure 24-14, B). Typically,the ascending colon would be seen on the right side at thislevel. However, in this individual, structures on the right sideare more superior than usual. The mesentery proper (1) holdsloops of the small intestine (3) in place within the peritonealcavity (2) (SST Figure 24-16).

Muscular SystemThe psoas major muscles (14) are located lateral to the

vertebral body and the iliacus muscles (15) are on the medialsurface of the ilium (SST Figure 11-29, A). The gluteus mediusmuscles (16) are on the lateral surface of the ilium (SST Figure11-28, A)

Nervous SystemThe cauda equina should be present, but is missing from

this section.

Skeletal SystemThe superior part of the ilium (6) (SST Figure 7-1 and 7-26).

The superior part of the opening posterior to the body (9) of thefifth lumbar vertebra is the vertebral canal (8). The inferior partof this opening is the beginning of the sacral canal (7).

Urinary SystemThe ureters (5) extend from the kidneys to the urinary

bladder (SST Figure 26-1, A). The ureters are located justanterior to the psoas major muscles.

47

111455

17

14

18

12


41/55

1. Small intestine2. Mesentery proper3. External iliac artery4. External iliac vein5. Internal iliac vein6. Internal iliac artery7. Ureter

8. Rectum9. Body of sacral vertebra

10. Sacral canal11. Piriformis muscle12. Gluteus maximus muscle13. Gluteus medius muscle14. Gluteus minimus muscle

15. Ilium16. Iliopsoas muscle17. Sigmoid colon (CT only)18. Urinary bladder (CT only)19. Ureter (CT only)

SECTION 21 48

1

3

2

4

16

15

5

6

7

8

9

10

11

12

1314

2

3


42/55

Level: Through the sacrum atS3. Pelvic cavity, through the

rectum.

CT image. The descending colongives rise to the sigmoid colon, whichforms an s-shaped loop to join therectum. The sigmoid colon (17) canbe seen along the midline just before

it joins the rectum (8). This CT alsoshows the urinary bladder (18) withthe right ureter (19). To see theurinary bladder and ureter in thecadaver, see Section 22.

R L

SECTION 21


Cardiovascular SystemThe common iliac arteries branch to form the external iliac

arteries (3) and the internal iliac arteries (6). The external iliacarteries project from the posterior abdominal wall toward thelower limbs, and the internal iliac arteries extend to the pelviccavity (SST Figure 21-9, A). Note the calcification within the leftinternal iliac artery. The external iliac veins (4) and internal iliacveins (5) are inferior to where they join the common iliac veins(SST Figure 21-17). The external iliac veins return from thelower limbs to the posterior abdominal wall, and the internaliliac veins return from the pelvic cavity.

Digestive SystemPart of the small intestine (1), mesentery proper (2), and the

rectum (8) are visible (SST Figure 24-9 and 24-14, A).

Muscular SystemThe iliacus and psoas major muscles converge to form the

iliopsoas muscle (16) (SST Figure 11-29, A). Note also thegluteus maximus (12), gluteus medius (13), gluteus minimus(14), and piriformis muscles (11) (SST Figure 11-28).

Nervous SystemSacral nerves from the cauda equina continue inferiorly

within the sacral canal, but are not easily seen in this sectionbecause of surrounding connective tissue.

Skeletal SystemThe ilium (15) of each coxa and the body of a sacral

vertebra (9) are evident (SST Figure 7-26). The sacral canal (10)is mostly filled with fat and connective tissue (SST Figure 7-18,F).

Urinary SystemThe ureters (7) continue inferiorly (SST Figure 26-1, A).

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1. Urinary bladder2. Ureter3. Pubis4. Ilium5. Head of femur6. Ischium

7. Gluteus minimus8. Gluteus medius9. Gluteus maximus

10. Rectum11. Sacral hiatus12. Greater trochanter

13. Prostatic venous plexus14. External iliac vein15. External iliac artery16. Seminal vesicle (CT only)

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Level: Through the sacrum atS5. The urinary bladder.

CT image. The urinary bladder (1) isalmost completely filled with contrastmedium. Note the followingrelationships: the urinary bladder isanterior, the rectum (10) is posterior,

and the seminal vesicles (16) arebetween the urinary bladder andrectum. The seminal vesicles are justinferior to the venous plexus seen inthe cadaver section.

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SECTION 22


Cardiovascular SystemThe external iliac arteries (15) continue toward the lower

limbs, and the external iliac veins (14) return from the lowerlimbs (SST Figure 21-11 and 21-19). The prostatic venous plexus(13) is a network of vessels that drains blood from the penis,urinary bladder and prostate gland into the internal iliac vein.

Digestive SystemThe rectum (10) continues inferiorly (SST Figure 24-14, A).

Muscular SystemThe gluteus maximus (9), gluteus medius (8), and gluteus

minimus (7) continue inferiorly (SST Figure 11-28).

Skeletal System

On the left side, the ilium (4), ischium (6), and pubis (3) ofthe coxa are cut, showing the head of the femur (5) within theacetabulum. The cut on the right side is at a slightly lowerlevel, showing more of the femur head and the greatertrochanter of the femur (12). The sacral hiatus (11) is posteriorto the rectum (SST Figure 7-18, F and 28-1). Clinically, the sacralhiatus can be used as an entry way for the injection ofanesthetic around spinal nerves within the sacral canal.

Urinary SystemThe urinary bladder (1) extends superiorly from the pelvic

cavity (SST Figure 26-1). Note the thick muscular wall of theurinary bladder (SST Figure 26-7, C). The right ureter (2) can beseen connecting to the urinary bladder (SST Figure 28-1, A).

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1. Symphysis pubis2. Pubis3. Acetabulum4. Head of femur5. Neck of femur6. Greater trochanter of femur

7. Ischium8. Coccyx9. Gluteus maximus muscle

10. Rectum11. Prostate gland12. Obturator internus muscle

13. Anterior thigh muscle14. Adductor muscle15. Femoral artery16. Femoral vein17. Urethra (CT only)

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Level: Male pelvis, through thehead of the femur.

CT image. The urethra (17) passesinferiorly through the prostate gland.A cathether within the urethra is usedto inject contrast media into theurinary bladder. Note the white

circle surrounded by black in therectum (10). The white circle is acontrast-filled cathether used to injectcontract media into the digestivetract. The black circle is an air-filledballoon around a cather, which helpsto hold the cather in place.

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SECTION 23


Cardiovascular SystemThe external iliac artery has passed through the femoral

sheath to become the femoral artery (15) (SST Figure 21-11).The femoral vein (16) is about to enter the femoral sheath and

become the external iliac vein (SST Figure 21-19).

Digestive SystemThe sigmoid colon gives rise to the rectum (10) (SST Figure

24-14, A).

Muscular SystemThe obturator internus (12) is a lateral hip rotator (SST

Figure 11-28, B). The adductor muscles (14) are separated fromthe anterior thigh muscles (13) by a connective tissue partitioncontaining blood vessels and nerves (SST Figure 11-29). Thegluteus maximus (9) continues inferiorly (SST Figure 11-28, A).

Reproductive SystemThe prostate gland (11) is located inferior to the urinary bladderand anterior to the rectum (SST Figure 28-1, A). A physiciancan check for a prostatic tumor by palpating (feeling) theprostate gland through the rectal wall.

Skeletal SystemThe head (4), neck (5), and greater trochanter (6) of the

femur is cut (SST Figure 7-30). The head of the femurarticulates with the acetabulum (3) of the coxa, which issectioned through the pubis (2) and ischium (7) (SST Figure 7-27, B). Anteriorly, the two pubic bones are joined at thesymphysis pubis (1) (SST Figure 7-26). The coccyx (8) isposterior to the rectum (SST Figure 7-15, A and 28-1).

Urinary SystemThe prostatic urethra passes through the prostate gland

(SST Figure 28-5). The urethra is collapsed and not visible inthis section. A prostatic tumor can compress the urethra,making urination difficult.

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1. Corpora cavernosa2. Corpus spongiosum3. Spermatic cord4. Spongy urethra5. Bulb of penis6. Great saphenous vein7. Femoral artery

8. Femoral vein9. Femoral nerve

10. Adductor muscles11. Anterior thigh muscles12. Ischium13. Femur14. Posterior thigh muscles

15. Gluteus maximus muscle16. Anal canal17. External anal sphincter18. Yellow marrow19. Crura of penis (CT only)20. Crena ani21. Nates

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Level: Male pelvis, through theinferior portion of the ischium.

CT image. The CT shows the bulb (5)and crura (19) of the penis, whichtogether form the root of the penis.Note the white circle surrounded byblack in the anal canal (16). The

white circle is a contrast-filledcathether used to inject contractmedia into the digestive tract. Theblack circle is an air-filled balloonaround a cather, which helps to holdthe cather in place. Not normallyseen in polite company, note thecrena ani (20), also known as thecluneal cleft, which is between thenates (21).

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SECTION 24


Cardiovascular SystemThe femoral artery (7) continues inferiorly (SST Figure 21-

11). The femoral vein (8) continues superiorly. The greatsaphenous vein (6) projects superiorly to join the femoral vein(SST Figure 21-19). The great saphenous vein is superficial andfunctions to drain superficial parts of the lower limb.

Digestive SystemThe anal canal 16) is surrounded by the external anal

sphincter (17), which allows voluntary control of defecation(SST Figure 24-14, A). Enlarged veins under the skin in thisregion produce external hemorrhoids.

Muscular SystemThe adductor muscles (10) are separated from the anterior

thigh muscles (11) by a connective tissue partition containingblood vessels and nerves (SST Figure 11-29). The gluteusmaximus (15) (SST Figure 11-28, A) covers the posterior thighmuscles (14), which attach to the ischium (SST Figure 11-30)

Nervous SystemThe femoral nerve (9) is located lateral to the femoral artery

(SST Figure 14-14).

Skeletal SystemThe ischium (12) and femur (13) can be seen (SST Figures 7-

27, B and 7-30). Note the yellow marrow (18) within themedullary cavity of the femur (SST Figures 6-3 and 6-4)

Reproductive SystemThe corpora cavernosa (1) form the sides and dorsum of the

penis. The corpus spongiosum (2) of the penis extendsposteriorly to form the bulb of the penis (5) (SST Figure 28-6).The spermatic cords (3) connect inferiorly to the testes (SSTFigure 28-5).

Urinary SystemThe spongy urethra (4) passes through the penis (SST

Figure 28-6). 55

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1. Mons pubis2. Symphysis pubis3. Pubis4. Femoral vein5. Great saphenous vein6. Femoral artery7. Femoral nerve

8. Obturator foramen9. Head of femur

10. Neck of femur11. Greater trochanter of femur12. Ischium13. Urethra14. Vagina

15. Levator ani muscle16. Anal canal17. Anal columns18. Urinary bladder (CT only)19. Uterus (CT only)20. Sigmoid colon (CT only)21. Rectum (CT only)

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Level: Female pelvis throughthe pubic bones.

CT image. This CT is superior to thecadaver section. Note the urinarybladder (18) just posterior to thepubic bones. The pear-shaped uterus(19) is located centrally in the pelvic

cavity. The sigmoid colon (20)extends to the rectum (21).

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SECTION 25


Cardiovascular SystemThe femoral arteries (6) (SST Figure 21-11), femoral veins (4)

and great saphenous veins (5) (SST Figure 21-19).

Digestive SystemThe anal canal (16) is present (SST Figure 24-14, A). Note

the vertical anal columns (17). Enlargement of veins within theanal columns produces internal hemorrhoids.

Muscular SystemThe levator ani muscle (15) helps to form the pelvic floor

(SST Figure 11-18, B). Parts of the levator ani can be namedseparately: the pubococcygeus extends between the pubic boneand coccyx, and more inferiorly, puborectalis wraps around thejunction of the rectum and anus. The puborectalis pulls theinferior rectum anteriorly, keeping the anorectal junction closed,

except during defecation, when the muscle relaxes.

Nervous SystemThe femoral nerve (7) is located lateral to the femoral artery

(SST Figure 14-14).

Reproductive SystemThe vagina (14) is located anterior to the anal canal (SST

Figure 28-8). The mons pubis (1) is anterior to the pubic bones(SST Figure 28-13).

Skeletal SystemThe head (9), neck (10), and greater trochanter (11) of the

femur is cut (SST Figure 7-30). The coxa is sectioned throughthe ischium (12) and pubis (3). Note the obturator foramen (8),filled with connective tissue (obturator means occluded) (SSTFigure 7-27, B). Anteriorly, the two pubic bones are joined atthe symphysis pubis (2) (SST Figure 7-26).

Urinary SystemThe urethra (13) extends inferiorly (SST Figure 28-8). It

passes through a small retropubic space filled with loose

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FIGURE 5A CHOROID PLEXUSPAPILLOMA T1 MRI. A papilloma is anonspreading, benign epithelial tumor (T).Although not cancerous, these tumors canenlarge and compress surrounding tissues,impairing their normal function. It can alsoimpair cerebrospinal fluid flow, producinghydrocephalus (see Figure 6).

Level: Transversesection through theorbits, midbrain,and lateral ventri-cles. Compare toSection 3.

FIGURE 5B The choroid plexuses consist ofspecialized epithelial cells, connective tissue,and blood vessels. The specialized epithelialcells are called ependymal cells. The choroidplexuses produce cerebrospinal fluid, which issecreted into brain spaces called the ventricles.

Level: Sagittalsection through theright orbit.Compare to Figure3.

FIGURE 5C Typically, these papillomas formin the lateral ventricles in children, and thefourth ventricle in adults. This series ofmagnetic resonance images demonstrates thepower of the computer to reconstruct an imagein three different planes.

Level: Frontalsection near theexternal auditorymeatus. Viewedfrom the front.Compare to Figure4.

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FIGURE 6 HYDROCEPHALUSCT image. Hydrocephalus is an accumulationof cerebrospinal fluid within brain spaces calledthe ventricles (V). The increased fluid volumeproduces pressure that expands the ventriclesand compresses brain tissue. The shunt (S)seen in the CT is a drainage tube that removescerebrospinal fluid from the ventricles.

Level: Throughthe superior part ofthe braincase.Compare to Section1.

FIGURE 7 GUNSHOT TO THE HEADCT image. A bullet has entered the left side ofthe skull (arrow). The exit wound on the rightside is larger than the entry wound. Note themassive fractures of the skull bones, withaccompanying bone and bullet fragments.

Level: Throughthe superior part ofthe braincase.

FIGURE 8 CEREBRAL HEMORRHAGET2 MRI. Nonflowing blood appears white in aT2 MRI. Trauma to the head has produced asubdural hematoma (SDH), and a cerebralbleed (CB) has resulted in an accumulation ofblood that has also filled a lateral ventricle (V).

Level: Throughthe superior part ofthe braincase.

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FIGURE 9 MENINGIOMA T1 MRI. Themeninges are three membranes surrounding the

brain and spinal cord. From super-ficial todeep, the meninges are the dura mater,arachnoid, and pia mater. A meningioma is abenign, encapsulated tumor (T) that arises fromthe arachnoid. This meningioma iscompressing the surrounding nervous tissue.

Level: Throughthe superior part ofthe braincase.Compare to Section1.

Figure 10 LUNG TUMOR CT image.Cancerous lung tumor in a person whochronically smoked. The tumor has partiallyoccluded the subclavian vein (SV), which isfilled with contrast medium.

Level: Through T3.Compare to Section10.

FIGURE 11 PNEUMOCYSTIC PNEUMONIACT image emphasizing lung connective tissue.Pneumocystic pneumonia occurs in individ-uals with depressed immunity, such as AIDSpatients. The right lung is normal, whereas theleft lung has become dense and fibrotic. Lungdamage has also resulted in air (black) escapinginto tissues outside the ribs (arrow).

Level: Through T8.Compare to Section13.

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FIGURE 12 SPLENIC MASS CT image. CTscan of the spleen is considered the best tool fordiagnosing splenic disorders such as tumors,abscesses, or cysts (C).

Level: Level:Through T12.Compare to Section16

FIGURE 13 PANCREATIC CYST CT image.The cyst (C) contains pancreatic juices and deadtissue. Pancreatic cysts are commonly found incases of chronic pancreatitis. Leakage andactivation of pancreatic juices within thepancreas results in the digestion anddestruction of the pancreas. Often found inchronic alcoholics.

Level: Through L1.Compare to Section17.

FIGURE 14 RENAL CARCINOMACT image. Renal cancer is responsible forabout 3% of cancers. If the cancer is confined tothe kidney, removal of the kidney results in afive-year survival rate of 50% to 80%. If thetumor (T) is locally invasive, as in this case, thesurvival rate drops to 25% to 50%.


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FIGURE 15 KNIFE WOUND TO KIDNEYCT image. The arrow indicates the locationwhere the left kidney has been damaged by aknife. Note the bleeding (B) around the kidney.


FIGURE 16 AORTIC ANEURYSM CT image.An aneurysm (A) is a dilation of an artery (SSTp. 673). As the artery enlarges, the dangerincreases that the artery will rupture (SST p.694). A rupture of the aorta usually results indeath. In the brain, a rupture can cause astroke (SST p. 430).

Level: Through L4.Between Sections19 and 20.

FIGURE 16 PELVIC MASS CT image. Alarge pelvic tumor (T) is compressing theurinary bladder (B).

Level: Throughthe sacrum at S3.Compare to Section21.

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156957800 Atlas Sectiuni Anatomie

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